What is the association between visit-to-visit heart rate variability (VVHRV) and all-cause mortality in patients with atrial fibrillation (AF)?
Heart-Rate-Variability & Autonomic Tools, studied in 3983 participants (Annals of Noninvasive Electrocardiology 2024, PMID 38288511) — specifically, the 1st quartile had hazard ratios of 2.28 (vs 2nd) and 2.23 (vs 3rd), while the 4th quartile had hazard ratios of 1.82 (vs 2nd) and 1.78 (vs 3rd). Scope: 3983 participants, and the abstract states no limitations.
Source: Annals of Noninvasive Electrocardiology 2024, PMID 38288511 ↗ · Research map · How Magellan grades evidence · evidence confidence: medium
Annals of Noninvasive Electrocardiology · 2024 · PMID 38288511 · DOI 10.1111/anec.13094
Both very low and very high heart rate variability between doctor visits are linked to a higher risk of death in people with atrial fibrillation.
The question
What is the association between visit-to-visit heart rate variability (VVHRV) and all-cause mortality in patients with atrial fibrillation (AF)?
What they tested
The relationship between VVHRV and the prognosis of AF is uncertain, but previous studies suggest a correlation between VVHRV and adverse outcomes.
How they did it
The study examined 3983 participants with AF from the AFFIRM study. VVHRV was measured using the standard deviation of heart rate (HRSD), and patients were divided into four quartiles based on HRSD. Cox proportional hazard regressions were used to estimate hazard ratios for all-cause mortality.
What they found
During an average follow-up of 3.5 years, 621 participants died. Both the lowest and highest quartiles of HRSD independently predicted an increased risk of all-cause mortality compared to the second and third quartiles, showing a U-shaped relationship. Specifically, the 1st quartile had hazard ratios of 2.28 (vs 2nd) and 2.23 (vs 3rd), while the 4th quartile had hazard ratios of 1.82 (vs 2nd) and 1.78 (vs 3rd).
| 1st vs 2nd Quartile | 2.28 | |
|---|---|---|
| 1st vs 3rd Quartile | 2.23 | |
| 4th vs 2nd Quartile | 1.82 | |
| 4th vs 3rd Quartile | 1.78 |
Hazard ratios for all-cause mortality comparing the lowest (1st) and highest (4th) quartiles of HRSD to the middle (2nd and 3rd) quartiles.
What it means
In patients with AF, both lower and higher visit-to-visit heart rate variability are associated with an increased risk of all-cause mortality, forming a U-shaped curve.
Limitations
The abstract does not explicitly state any limitations of the study.
Where the published abstract does not list limitations, we say so rather than inventing them. Read the full paper on PubMed before drawing conclusions.
The paper at a glance
| Title | The impact of visit-to-visit heart rate variability on all-cause mortality |
|---|---|
| Journal | Annals of Noninvasive Electrocardiology |
| Year | 2024 |
| PMID | 38288511 ↗ |
| DOI | 10.1111/anec.13094 ↗ |
| Topic | Sleep, circadian rhythm & stress |
Read the source: PubMed record (authors, abstract, full citation) ↗ · Publisher via doi.org ↗
Where Magellan uses this paper
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Biometric Wearables (Sleep, HRV & Recovery)
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Smart Body-Composition Analysis
The biomarkers a body-composition scale tracks are each linked to healthy aging: higher body-fat percentage and visceral adiposity are associated with greater cardiovascular and metabolic risk and, in general adult populations, higher all-cause mortality, while low muscle mass (sarcopenia) predicts disability and…
Consumer biometric wearables—smartwatches, wrist-worn bands and finger rings from makers such as Apple…
Consumer biometric wearables—smartwatches, wrist-worn bands and finger rings from makers such as Apple…
Consumer biometric wearables—smartwatches, wrist-worn bands and finger rings from makers such as Apple…
Consumer biometric wearables—smartwatches, wrist-worn bands and finger rings from makers such as Apple…
Consumer biometric wearables—smartwatches, wrist-worn bands and finger rings from makers such as Apple…
Consumer biometric wearables—smartwatches, wrist-worn bands and finger rings from makers such as Apple…
Research describes the compound or intervention studied. It is not a claim about any specific product.
Molecules & mechanisms in this paper
Each of these is named in the paper’s own words above. Open the monograph for the full mechanism and its other citations.
Cite this page
These citations point at this summary. To cite the original paper with its full author list, use the PubMed record or doi.org.
Magellan Longevity. (2026). What is the association between visit-to-visit heart rate variability (VVHRV) and all-cause mortality in patients with atrial fibrillation (AF)? [Plain-English summary of Annals of Noninvasive Electrocardiology 2024, PMID 38288511, DOI 10.1111/anec.13094]. Magellan Longevity. https://magellanlongevity.com/study/hrv.html@misc{magellan_hrv,
title = {What is the association between visit-to-visit heart rate variability (VVHRV) and all-cause mortality in patients with atrial fibrillation (AF)?},
author = {{Magellan Longevity}},
year = {2026},
howpublished = {\url{https://magellanlongevity.com/study/hrv.html}},
note = {Plain-English summary of PubMed PMID 38288511; DOI 10.1111/anec.13094; Annals of Noninvasive Electrocardiology 2024. Reviewed by Gabriel Radu, DO},
urldate = {2026-08-11}
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